Community-based Health Professionals Research Articles

How Community-Based Health and Social Care Professionals Support Unpaid Caregivers: Experiences From One Health Authority in Ontario, Canada.

In Ontario, Canada, rising rates of caregiver distress have been the 'canary in the coal mine' for a health system out of balance with the needs of an ageing population. Community-based health and social care professionals are well placed to play an important role in the caregiver support process; however, a gap has remained in the understanding of if and how caregiver support strategies are operationalized or experienced by community service providers (CSPs). The goal of this study was to describe how CSPs interpreted policy and how those interpretations may enable their work in supporting unpaid caregivers. Using a qualitative constructionist design, we interviewed 24 participants and reviewed 92 publicly available documents. Braun and Clarke's method of thematic analysis was used for analysis strategy. Four overarching themes were identified: (1) community care as a priority, (2) sidewalk accountability, (3) creative care planning through partnerships, and (4) challenges to care delivery. We found that the importance of caregivers to the health system was reflected in organizational policy and strategy. There is an opportunity to improve health outcome for caregivers and the population alike through strong leadership and a clear shared vision. Our findings also suggested that social capital was a significant factor in enabling providers in their work, leveraging long-standing relationships, and accumulated local knowledge to implement highly creative care plans.

GPs' views on emergency care treatment plans: an online survey.

A holistic approach to emergency care treatment planning is needed to ensure that patients' preferences are considered should their clinical condition deteriorate. To address this, emergency care and treatment plans (ECTPs) have been introduced. Little is known about their use in general practice. To find out GPs' experiences of, and views on, using ECTPs. Online survey of GPs practising in England. A total of 841 GPs were surveyed using the monthly online survey provided by medeConnect, a market research company. Forty-one per cent of responders' practices used Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) plans for ECTP, 8% used other ECTPs, and 51% used Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) forms. GPs were the predominant professional group completing ECTPs in the community. There was broad support for a wider range of community-based health and social care professionals being able to complete ECTPs. There was no system for reviewing ECTPs in 20% of responders' practices. When compared with using a DNACPR form, GPs using a ReSPECT form for ECTP were more comfortable having conversations about emergency care treatment with patients (odds ratio [OR] = 1.72, 95% confidence interval [CI] = 1.1 to 2.69) and family members (OR =1.85, 95% CI = 1.19 to 2.87). The potential benefits and challenges of widening the pool of health and social care professionals initiating and/or completing the ECTP process needs consideration. ReSPECT plans appear to make GPs more comfortable with ECTP discussions, supporting their implementation. Practice-based systems for reviewing ECTP decisions should be strengthened.

Stakeholders' Perspectives on the Quality of End-of-Life Health Care Services for Chronic Obstructive Airways Disease: A Focus Group Study.

Delivery of end-of-life care for severe chronic obstructive pulmonary disease (COPD) has been hampered by an unpredictable disease trajectory and poor integration of health care and social services. To critically explore the perspectives, values, and experiences of stakeholders in COPD end-of-life healthcare services in a large district in Aotearoa New Zealand. Focus groups analysed utilising critical theory and Actor-Network Theory. Stakeholders in end-of-life COPD healthcare services were purposively sampled from a large healthcare network in Canterbury, Aotearoa New Zealand to participate in seven focus groups (bereaved carers, community-based health professionals, non-Māori, non-Pacific patients, and support people (two groups), Māori patients, supporters and health professionals, Pacific patients, support people and health professionals, and hospital-based health professionals). Participants discussed end-of-life care services for people with COPD. Transcripts were coded utilising descriptive and structural coding to develop themes related to provision of quality care. Participants were positioned as experts. We considered how the themes arising supported and disrupted the healthcare network for end-of-life COPD. Five themes related to quality of care for end-of-life COPD were identified: compassion, competence, community, commitment, and collaboration. The absence of any of these five themes required for quality care led to power imbalances within healthcare systems. Power inequities created disconnection among stakeholders which then disrupted commitment, community, and collaboration. A dysfunctional healthcare network impeded compassion between stakeholders and did not support their competence, leading to lower quality care. All five themes were identified as essential to delivery of high-quality end-of-life care in COPD. Stakeholders' perspectives of end-of-life care for COPD identified of core features of a health system network that enabled or impeded the actions of stakeholders and allocation of resources to provide quality care.

Status of Women after Joining the Profession as Lady Health Workers

In Pakistan's reproductive and basic healthcare system, which serves women and children, a key group of community-based health professionals is known as Lady Health Workers (LHWs), also known as Community Health Workers. The objective of this study was to identify the opinions and experiences of these women in relation to their status in the family and community after starting their careers as LHWs. Primary data was gathered using a quantitative research approach from 262 respondents who were chosen at random from a list of LHWs employed in the rural areas of Lahore District. For data collection, an interview schedule was used. According to the study's findings, mostly respondents said that their family had complained that they had neglected them because of their work obligations. Majority respondents reported that the community people respected and valued them for their services, but they never got any incentive from their respective department/government on good performance. Based on the study's findings, it is recommended that LHWs be given a supportive work environment so they may manage their job and family obligations.

Two-year longitudinal associations between nutritional status and frailty in community-dwelling older adults: Korean Frailty and Aging Cohort Study

BackgroundKorea is expected to become a super-aged society in 2026, and improving nutritional status, which is directly related to health problems, is therefore important for increasing healthy life expectancy. Frailty is the most complex phenotype of aging, and leads to adverse health outcomes, disability, poor quality of life, hospitalization, and mortality. Malnutrition is a major risk factor for frailty syndrome. This study aimed to investigate the incidence of pre-frailty or frailty in the second wave (T2, 2018–2019) according to general characteristics and nutritional status in the first wave (T1, 2016–2017); and examine the longitudinal association of nutritional status in T1 and the incidence of pre-frailty or frailty in T2 among older adults living in a community.MethodsA secondary data analysis was performed using the Korean Frailty and Aging Cohort Study (KFACS). Participants comprised 1125 community-dwelling older Korean adults aged 70–84 years (mean age: 75.03 ± 3.56 years; 53.8% males). Frailty was assessed using the Fried frailty index, and nutritional status was assessed using the Korean version of the Mini Nutritional Assessment Short-Form and blood nutritional biomarkers. Binary logistic regression was used to identify longitudinal associations between the nutritional status at T1 and pre-frailty or frailty at T2.ResultsOver the two-year follow-up period, 32.9% and 1.7% of the participants became pre-frail and frail, respectively. After the potential confounders were adjusted (sociodemographic, health behaviors, and health status characteristics), pre-frailty or frailty had a significant longitudinal association with severe anorexia (adjusted odds ratio [AOR], 4.17; 95% confidence interval [CI], 1.05–16.54), moderate anorexia (AOR, 2.31; 95% CI, 1.46–3.64), psychological stress or acute disease (AOR, 2.61; 95% CI, 1.26–5.39), and body mass index (BMI) less than 19 (AOR, 4.11; 95% CI, 1.20–14.04).ConclusionsAnorexia, psychological stress, acute disease, and low BMI are the most significant longitudinal risk factors for pre-frailty or frailty in older adults. As nutritional risk factors may be preventable or modifiable, it is important to develop interventions targeting the same. Community-based health professionals in health-related fields should recognize and manage these indicators appropriately to prevent frailty among older adults living in the community.

Community-based health professionals in face of crisis – a practice example from Bremen, Germany

Abstract At the end of 2020, a district-based analysis of Covid-19-infection rates in Bremen uncovered differences between socially deprived and “better off” areas. The first analysis conducted on a district level in Germany revealed a social gradient in the Covid-19-affectedness with deprived areas having above-average incidences. These areas are characterized by poor living conditions, high migrant population, low education and health literacy levels, language barriers and precarious job situations. Bremen's Health Senator acted on this challenge early on, initiated and financed the deployment of community-based health professionals (CHP) in disadvantaged areas to tackle the rising Covid-19-rates while reducing social inequalities and promoting health literacy. The CHPs’ work is coordinated by the Association for Health & Academy for Social Medicine Lower-Saxony. The 14 CHP are multilingual, with a background in health professions, social work and public health. They cooperate with local partners in 18 disadvantaged districts in Bremen and Bremerhaven. In 2021, work focused on outreach work, low-threshold provision of multilingual information (e.g., on regulations, vaccination) and the support of local vaccination campaigns. Bremen currently has the highest vaccination coverage in Germany (87,5% of population with primary series, national average: 76,2%; 07/2022). Since 2022, CHPs’ work has shifted to health promotion activities aimed at mitigating the effects of the pandemic, e.g., physical inactivity, mental stress. Bremen was the first German city to pilot a large-scale implementation of CHP in socially disadvantaged areas. Due to their continuous presence, CHP quickly became people of trust and are integrated into local structures. Their work has received huge attention both in professional contexts and public media. The low-threshold outreach-work and close cooperation with local partners has high potential to address other health challenges in disadvantaged communities. Key messages

Cross-sectorial collaboration on policy-driven rehabilitation care models for persons with neuromuscular diseases: reflections and behavior of community-based health professionals

BackgroundPersons with neuromuscular diseases (NMDs) often experience complex rehabilitation needs due to the disease’s impact on their functioning and progression of their diseases. As a consequence of legislation and “policy power”, community-based health professionals function as gatekeepers to the rehabilitation trajectory for persons with NMDs in a field where the other professionals are the specialists.AimTo investigate community-based health professionals’ reflections on and behaviors regarding collaboration with a tertiary rehabilitation hospital in a cross-sectorial rehabilitation care model with the overall aim of providing high quality rehabilitation for persons with NMD.MethodsThe design is qualitative and uses interpretive description methodology and the theoretical lens of Edgar Schein’s three levels of organizational culture and leadership.An ethnographic fieldwork was conducted from September 1, 2019 to January 30, 2020. Eighty-four community-based health professionals were included and 17 of them were interviewed in four semi-structured focus group interviews (n = 10) and seven individual interviews (n = 7). In addition, 151 pages of observation data were generated. The study adheres to the COREQ guidelines.ResultsThe analysis showed three themes of importance for the collaboration: Policy and legislation navigation represented that collaboration on rehabilitation was affected by legislation as a management tool with “the case” as the core element, and goal dilemmas. Cross-sectorial knowledge exchange promoted collaboration on coordinated and facilitated rehabilitation and knowledge sharing as a firm anchoring. Patient ownership negotiations implied collaboration was influenced by knowledge founded power and gatekeeping as a navigation tool.ConclusionThree levels of organizational culture and leadership were identified, and this overall structure guided the community-based health professionals in their work and in the complex organizational landscape of collaboration between disconnected healthcare systems. The findings provided insight into behavior and attitudes and the content and the values held by the professionals collaborating across sectors. Future collaboration in rehabilitation models should be multiprofessional and team based. The findings emphasize that it is imperative that managements and professionals strive to strengthen the structure of the collaborative team spirit because this will ensure well-planned, coordinated, and conducted rehabilitation for persons with NMD and enable and support future cross-sectorial collaboration in this rehabilitation model for these persons.

Effects of a Social and Emotional Competence Enhancement Program for Adolescents Who Bully: A Quasi-Experimental Design.

Background: The purpose of this study was to develop a social and emotional competence enhancement (SECE) program as an intervention for adolescents who bully, and to investigate its effects on school bullying behavior and mental health. Methods: A pre-posttest, 1-month follow-up nonequivalent control group quasi-experimental design was used. In total, 71 school bullies were included in the analysis. Results: The effects of this program were significant with regard to group-by-time interaction effects on social competence, emotional regulation, empathy, and school bullying behavior at the 1-month follow-up. Conclusions: The results indicate that the SECE program was effective at reducing school bullying behavior in adolescents who bully. School and community-based mental health professionals can provide feasible interventions that can be used in the short term to reduce school bullying behavior in adolescents who bully.

Survey of delivery of parenteral antimicrobials in non-inpatient settings across Europe

Delivery of parenteral antimicrobials in non-inpatient settings (DPANS) may be through a dedicated outpatient parenteral antimicrobial therapy (OPAT) service, co-ordinated by hospital- or community-based specialised teams, or via an infusion service involving community-based health professionals (nurses, general practitioners) without centralised hospital oversight, or through ad hoc arrangements. DPANS varies among countries. Our objective was to describe how DPANS is organised at a national level in European countries. A survey (65-item self-administered questionnaire) was conducted from February-June 2019 among infection specialists in 34 European countries on behalf of the ESCMID Study Group for Antimicrobial Stewardship (ESGAP) and the British Society for Antimicrobial Chemotherapy (BSAC) OPAT initiative. Most countries (28/34; 82.4%) participated in the survey. DPANS was available in almost all (27/28; 96.4%) responding countries. DPANS was predominantly provided either via specialised OPAT services (17/28; 60.7%) or via infusion services (16/28; 57.1%), with 11 countries (39.3%) providing both services. A formal OPAT team structure with specifically trained staff was reported in only six countries (6/17; 35.3%). Some countries (4/28; 14.3%) had no structured services but practiced DPANS via ad hoc arrangements. The costs of all stages of the process were covered for patients managed by specialised OPAT/infusion services, either completely, partially or for specific patient groups in the majority (20/28; 71.4%) of countries. The main barriers to implement OPAT/infusion services were lack of organisational structure or guidelines. In conclusion, DPANS with respect to availability and organisation is highly heterogeneous in Europe. National/European guidelines may help improve and standardise DPANS.

'Are we opening a can of worms?': Community-based occupational therapists' experiences working with clients with unexpected mental health issues.

General community occupational therapists (OTs) work with clients experiencing chronic and complex conditions, some living with one or more comorbid common mental health issues (such as anxiety, depression or distress). This study aimed to describe the perspectives of general community OTs of their engagement with clients experiencing mental health issues; their perceptions of the implementation of routine screening in their practice, and the knowledge, skills and support they need to identify and support their clients' mental health needs. Six focus groups were undertaken with general community OTs (n=21) from three Australian health services in rural, regional and metropolitan settings, between December 2020 and January 2021. Data were analysed using a team-based framework approach. Three key themes were identified: (1) OTs' experiences working with people with mental health issues; (2) impacts of engaging with clients experiencing mental health issues on OTs; and (3) implementing routine mental health screening in general community OT practice. The latter had two sub-themes: (i) identified considerations and (ii) education and system-level support needs. General community OTs frequently work with clients with mental health issues. These experiences impact their practice in multiple ways. This study highlights opportunities for integrating routine mental health screening into general community OT practice and identifies the system and educational development required to support this enhancement to practice. Supporting general community OTs to routinely screen for mental health issues will enhance collaborative client-centred care. Our findings may also have implications for other community-based health professionals and services, particularly those delivered in clients' homes.

Moral distress experienced by community service providers of home health and social care in Ontario, Canada.

Moral distress occurs when one knows a morally correct action to take but feels powerless to act the way one believes is right. Moral distress has been studied in many contexts but there remains a gap in our understanding of the phenomenon as it manifests outside of hospital-based settings. The aim of this study was to explore the nature of the moral distress experience among community-based health and social care professionals working with older adults and their caregivers. Using a qualitative constructionist design, we interviewed 24 participants from a single health authority in southwestern Ontario, Canada. Participants were both urban and rurally based. Data were collected in the winter and summer of 2020 and analysed using Braun and Clarke's thematic analysis strategy. Three factors: reluctant clients, human resource shortages and system challenges, contributed to the creation of perceived morally precarious care plans, resulting in symptoms of moral distress. Study participants described frustration, guilt, anger, and grief at not being able to act consistently with their core values and provide the amount and/or quality of care their clients and unpaid caregivers deserved. We consider possible reasons for our finding that community service providers did not always respond to the consequences of moral distress symptoms in a manner similar to those in acute care contexts. Our findings suggest that study participants may have been able to cultivate moral resilience in the face of moral distress through the positive reframing of adversity and therefore maintain their overall sense of moral integrity.

Exploring the knowledge of community-based nurses in supporting parents of preterm babies at home: A survey-based study.

AimThis study aimed to investigate the confidence levels, knowledge base and learning needs of community‐based nurses relating to the care of preterm babies and parents, to explore what education is required and in what format.DesignAn online survey methodology was used.MethodsA 32‐item questionnaire was distributed via social media platforms to community‐based nurses in Australia.ResultsDescriptive analysis was undertaken relating to knowledge base, confidence levels, previous training, learning and resource needs and barriers to education. It was deemed vital to expand confidence and knowledge in this area. Gaps in learning resources were identified and a need for more training in topics such as developmental outcomes, feeding, expected milestones, weight gain, growth trajectories and supporting parents. Online resources were the preferred format to teach key knowledge to community‐based health professionals, tailored to the specific features of preterm babies and support needs of parents.

FEELING LIKE A MOTHERLESS CHILD: WHEN YOUR VULNERABILITY MAKES YOU A VICTIM, YOU MAY BECOME VOICELESS TO SEX TRAFFICKING.

When a 16-year-old is addicted to drugs and engages in prostitution for money to purchase drugs, who is the predator and who is the prey? Is the minor a willing participant? Should it matter if he or she previously engaged in prostitution? This Article looks at United States v. Aundre Davis, a case in the United States Court of Appeals for the Sixth Circuit. In Davis, the United States District Court for the Northern District of Ohio at Toledo applied an undue-influence enhancement – a sentencing increase when a defendant unduly influences a minor to engage in prohibited sexual conduct – to Davis’s sentence. The appellate court concluded that the district court did not provide an adequate explanation for applying the sentencing enhancement and remanded the case to the district court for resentencing. This Article explores how other circuit courts have interpreted the undue-influence enhancement and also discusses the unforeseen or unintended consequences on the victim when an appellate court remands a human trafficking case to the trial court. When victims find their voices and decide to talk about their ordeals, they may not be sure what to say or who can help them. After escaping a trafficking situation, victims should not feel re-traumatized by the criminal justice system. Therefore, the author recommends specialized training for actors in the criminal justice system to learn about the dynamics of human trafficking and how to acknowledge the significant pain and trauma victims have experienced. That trauma affects a victim’s psychological, emotional, and physical well-being as well as their court testimony. Without trauma-informed practices, law enforcement, judges, attorneys, and social workers cannot successfully create partnerships with community-based organizations and mental health professionals, protect victims, prosecute traffickers, and prevent trafficking.

Improving community-based care for children with a rare condition: The example of long-segment congenital tracheal stenosis and perceptions of health professionals, parents and teachers

BackgroundLong segment congenital tracheal stenosis (LSCTS) is a rare, complex condition which is often poorly understood by community-based health professionals (HPs). Anecdotally, such HPs often lack confidence providing care for children, resulting in children being brought to the tertiary centre more frequently than necessary. We wanted to identify the information and support needs of HPs in primary and secondary care looking after a child with LSCTS, the views of those providing education to these children, and elicit parents’ perceptions about community-based services, to improve overall care for children and families. MethodQuestionnaires were sent to 175 community-based HPs and 34 teachers involved in the care of children with LSCTS. Face-to-face or telephone interviews were conducted with 12 parents of patients with LSCTS to establish their perceptions of community-based services. ResultsNinety (51%) completed questionnaires were returned from HPs and 18 (53%) from teachers. Responses indicated low levels of knowledge of LSCTS. Physical, practical and communication information needs were identified by all respondent groups, together with general and condition-specific concerns. Interviews with parents indicated that they thought the level of knowledge about LSCTS in the community was low, which had a negative impact on their willingness to consult local services. Better information provision for HPs, teachers and parents was identified as a means of improving outcomes. ConclusionProfessionals caring for children with LSCTS in the community and in schools have unmet information and support needs, with consequences for children, families, HCPs in both the community and tertiary hospital, and teachers.

Multidisciplinary perspectives and practices of wheelchair prescription for children with neuromuscular conditions

Purpose Clinical practice guidelines for paediatric neuromuscular disorders (NMDs) recommend timely provision of wheelchair equipment. The aim of this qualitative study was to understand healthcare professionals’ clinical perspectives and practices when recommending wheelchair equipment for the first time, as well as perceived barriers and enablers to timely wheelchair provision. Methods Twenty-one healthcare professionals (HCPs) from Australia and the United States participated in an interview (response rate: 88%, 16/21 women). Participants were from diverse disciplines, based in hospital or community health settings, and had at least one year of experience working in paediatric neuromuscular care. Results Child fatigue, falls and engagement in age-appropriate activity were common reasons for HCP’s wheelchair recommendation. HCPs were acutely aware of parents’ experiences of grief and loss throughout the wheelchair prescription process, and over half acknowledged the lack of psychological care available to families affected by NMDs. Multi-disciplinary collaboration, psychologically-informed care, and shared decision-making with stakeholders were perceived enablers of wheelchair transition. Barriers included limited access to equipment, lengthy funding processes and lack of funding for home and vehicle modifications. Conclusions Integrated psychosocial care is needed to support families throughout their child’s disease progression, including wheelchair transition. Implementation of readiness for change tools, and development of tailored informational resources is recommended. Improved access to equipment options and trials, and more efficient funding processes are highly likely to improve parental engagement throughout the wheelchair prescription process. Implications for rehabilitation Healthcare professionals express a strong demand for integrated psychosocial care within paediatric neuromuscular clinics to support families throughout transitions, including wheelchair introduction. Identifying parents’ readiness for change can inform their information and support needs, strengthen their decision-making capacity and facilitate timely wheelchair introduction. Stronger collaboration between hospital- and community-based health professionals working in paediatric neuromuscular care is recommended to facilitate knowledge exchange and support families’ transition to wheelchair use. Access to equipment options for extended loan or trial in the community can support timely wheelchair introduction.

A Qualitative Investigation Of Fitness Professional’s Perceived Barriers And Enablers To Community-based Cancer Exercise Programming

Access to community-based interventions is valuable for promoting regular exercise participation in cancer survivors. Although cancer survivors perceived exercise barriers have been consistently investigated, fitness professionals’ perceptions of the barriers and enablers to offering community-based exercise programming targeting cancer survivors has yet to be systematically explored. PURPOSE: The primary purpose of this study is to qualitatively investigate health and fitness professionals’ perceptions of barriers and enablers to offering community-based exercise programs targeting cancer survivors at their fitness and/or community centers. METHODS: A mixed-method qualitative case study approach incorporating web-based survey and semi-structured interview components was used to evaluate the fitness professionals’ programming perceptions. A total of 82 community-based health and fitness professionals were contacted about the web-based survey. A total of 7 subjects volunteered to participate in a follow-up semi-structured interview based on their consent to participate in the further interview as indicated on the initial survey. RESULTS: A total 12 survey responses (14.6%) were completed online and 7 of 12 (58.3%) of the individuals completed the semi structured interviews. Data analysis using content analysis and the constant comparative method process revealed 3 primary domains with 11 underlying themes: 1. Program Barriers: a. Education and Awareness; b. Physician Referral; c. Cost, and d. Care Along the Cancer Continuum; 2. Program Enablers a. Champion Advocacy, b. Sponsor/Funding, c. Personnel, and d. Propositional Solutions; and 3. Program Perceptions a. Social Support, b. Gym Atmosphere, and c. Cancer Specific Modifications. CONCLUSIONS: Findings from this mixed method, qualitative study identified multiple domains and themes articulating health and fitness professionals’ perceptions of key barriers, enablers, and programmatic aspects in offering community-based exercise cancer programming. These results have important implications for guiding the design and delivery of community-based exercise programs for cancer survivors and represent a meaningful advance in developing a clinic-to-community translational model of exercise-based supportive cancer care.

Mental Health, Risk Factors, and Social Media Use During the COVID-19 Epidemic and Cordon Sanitaire Among the Community and Health Professionals in Wuhan, China: Cross-Sectional Survey.

BackgroundThe mental health consequences of the coronavirus disease (COVID-19) pandemic, community-wide interventions, and social media use during a pandemic are unclear. The first and most draconian interventions have been implemented in Wuhan, China, and these countermeasures have been increasingly deployed by countries around the world.ObjectiveThe aim of this study was to examine risk factors, including the use of social media, for probable anxiety and depression in the community and among health professionals in the epicenter, Wuhan, China.MethodsWe conducted an online survey via WeChat, the most widely used social media platform in China, which was administered to 1577 community-based adults and 214 health professionals in Wuhan. Probable anxiety and probable depression were assessed by the validated Generalized Anxiety Disorder-2 (cutoff ≥3) and Patient Health Questionnaire-2 (cutoff ≥3), respectively. A multivariable logistic regression analysis was used to examine factors associated with probable anxiety and probable depression.ResultsOf the 1577 community-based adults, about one-fifth of respondents reported probable anxiety (n=376, 23.84%, 95% CI 21.8-26.0) and probable depression (n=303, 19.21%, 95% CI 17.3-21.2). Similarly, of the 214 health professionals, about one-fifth of surveyed health professionals reported probable anxiety (n=47, 22.0%, 95% CI 16.6-28.1) or probable depression (n=41, 19.2%, 95% CI 14.1-25.1). Around one-third of community-based adults and health professionals spent ≥2 hours daily on COVID-19 news via social media. Close contact with individuals with COVID-19 and spending ≥2 hours daily on COVID-19 news via social media were associated with probable anxiety and depression in community-based adults. Social support was associated with less probable anxiety and depression in both health professionals and community-based adults.ConclusionsThe internet could be harnessed for telemedicine and restoring daily routines, yet caution is warranted toward spending excessive time searching for COVID-19 news on social media given the infodemic and emotional contagion through online social networks. Online platforms may be used to monitor the toll of the pandemic on mental health.

The knowledge and learning needs of health professionals in providing support for parents of premature babies at home: A mixed-methods study

Premature babies and their families often require on-going community-based care after discharge from the neonatal unit. Parents themselves have identified the need for health professionals to understand the specific needs of parents of premature babies in order to provide the optimal support they require. This study aimed to explore the existing knowledge base and learning needs of community health professionals, to further understand how they can adequately support parents in the community with premature babies. A mixed-methods approach was used comprising a questionnaire, semi-structured interviews and secondary data analysis. Participants included thirteen Health Visitor [HV] students, eight educators and seven parents from a previous study. Thematic analysis revealed important insights into the knowledge and learning needs necessary to support parents of premature babies in the community. Three main themes emerged: development of prior knowledge; the importance of practice-based learning; learning and training needs. Knowledge, confidence and skills in relation to caring for parents with premature babies varied between individuals depending on their placement during training and subsequent experiences. While transferable skills in supporting parents in the community were present, more education and training in the specific needs of premature babies and parents would be welcomed. Tailored resources for community-based health professionals on the specific needs of the premature baby would enhance provision of optimal support for parents.

Self-Reported Pain Intensity and Depressive Symptoms Among Community-Dwelling Older Adults with Schizophrenia Spectrum Disorders.

Older adults with schizophrenia have some of the highest rates of both medical and psychiatric comorbidities. Despite this, little is known about comorbid pain and depressive symptoms in schizophrenia research. This study aimed to examine the associations between levels of pain intensity and depressive symptoms among community-dwelling adults aged 50years and older with schizophrenia spectrum disorders. Recruited from U.S. community mental health centers, participants reported on pain and depressive symptoms at the onset of the Helping Older People Experience Success (HOPES) study. Unadjusted and adjusted regression analyses were conducted. Higher pain intensity was associated with elevated depressive symptoms in all analyses, which is consistent with other studies in the general population. Given the widespread efforts to manage pain and related mental health complications in older adults without serious mental illnesses, it is likewise important that community-based mental health professionals monitor and address intense pain and related depressive symptoms among older adults with schizophrenia.

Religious Community Partnerships: a Novel Approach to Teaching Psychiatry Residents about Religious and Cultural Factors in the Mental Health Care of African-Americans.

Promoting awareness in residency training about the influence of religion on the doctor's and patient's ability to negotiate a patient-centered treatment plan is challenging and yet important for improving the quality of mental health care for religious individuals. This paper aims to explore the use of community partners and non-psychiatry faculty to provide this education within psychiatry residency programs. Fifty-one psychiatry residents at an academic psychiatric hospital took part in a 4-h interdisciplinary workshop aimed at improving doctors' overall approach to treating African-American Christian patients. Community-based African-American clergy and mental health professionals, hospital-based psychiatrists, and primary care physicians facilitated educational sessions. A majority of the facilitators were African-American. A pre- and post-workshop survey was administered to measure change in participant attitudes and comfort levels associated with exposure to the workshop. Paired t tests on three subscales were used to calculate change in attitudes on pre- to post-workshop surveys. Resident scores on each of the three factor subscales increased significantly between pre- and post-workshop assessments: comfort in discussions with patients about spirituality [t [17] = 2.758; p = 0.013]; willingness to collaborate with clergy [t [16] = 3.776; p = 0.002]; and importance of religion to mental health [t [17] = 3.645; p = 0.002]. Findings suggest that collaboration between academic and community-based clergy, physicians, and other mental health providers may be a feasible method of improving psychiatry trainees' comfort in addressing religion in psychiatric care to ultimately provide more culturally competent care.